Re: Speech eval time and treatment times

[Guest guest]

Collen,

Our outpatient speech evaluations average one hour. Treatment times average 45 minutes. You are right about economical services, especially since Speech evals and treatments tend to take longer than the other disciplines. Their productivity never comes close to matching PT and OT, so it is difficult to reconcile costs and expenses, especially now that Medicare pays per the fee schedule in outpatient settings.

Mark Dwyer, MHA, PT

Director of Rehabilitation Services

Bethany Medical Center

Kansas City, Kansas

mdwyer1@...

Speech eval time and treatment times>I am curisous to what other outpatient speech evaluation and treatment times >are for other facilities. We are seeing new evals for 2 hours and treatments >for 1 hour. My problem is that with reimbursement based on the procedure >rather than time, I do not feel we are providing economical services. We >have good care and good outcomes but that does not cut it as you all know. >We also see a lot of evaluation only patients that are refered to us by >school districts that I am told require 2 hours to evaluated and test. What >are you guys doing and how have you handled the switch from longer to shorter >treatment / eval times.>>Collen Queen, PT>Harlingen, Texas>>------------------------------------------------------------------------>>eGroups.com home: /group/ptmanager> - Simplifying group communications>>>>>

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[Guest guest]

Mark and Collen, what is your productivity standard for the speech

therapists. It is as you stated, difficult for them to be as productive

as the OT's and PT's. I have recently been placed in a management

position over speech therapists and am not sure what to use as a

benchmark. I supervise both acute inpatient and outpatient programs.

Thanks in advance for any guidance on this.

, PT

Providence Alaska Medical Center

Anchorage AK

yoshi@...

Mark Dwyer wrote:

>

> Collen,

>

> Our outpatient speech evaluations average one hour. Treatment times average

45 minutes. You are right about economical services, especially

since Speech eval

>

> Mark Dwyer, MHA, PT

> Director of Rehabilitation Services

> Bethany Medical Center

> Kansas City, Kansas

> mdwyer1@...

>

> Speech eval time and treatment times

>

> >I am curisous to what other outpatient speech evaluation and

> treatment times

> >are for other facilities. We are seeing new evals for 2 hours and

> treatments

> >for 1 hour. My problem is that with reimbursement based on the

> procedure

> >rather than time, I do not feel we are providing economical

> services. We

> >have good care and good outcomes but that does not cut it as you all

> know.

> >We also see a lot of evaluation only patients that are refered to us

> by

> >school districts that I am told require 2 hours to evaluated and

> test. What

> >are you guys doing and how have you handled the switch from longer to

> shorter

> >treatment / eval times.

> >

> >Collen Queen, PT

> >Harlingen, Texas

> >

>

>------------------------------------------------------------------------

> >

> >eGroups.com home: /group/ptmanager

> > - Simplifying group communications

> >

> >

> >

> >

> >

> ----------------------------------------------------------------------

> eGroups.com home: /group/ptmanager

> www. - Simplifying group communications

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[Guest guest]

In my outpatient department the standard for all therapist is have billable

time of 80% or 6.4 billable hours per day. It is easier for the OT and PT

because of dovetailing and double booking of patients. Speech is so one on

one that one cancellation or no show a day dramatically reduces their ability

to reach their productivity. (SLP noshow/cancelation is 30% in my clinic) Not

to mention drives them into the ground. I have been struggling secondary to

providing a service that I am losing money on because of reimbursement is so

low for speech (our payor mix is mostly Medicare and Medicaid). Since

Medicaid only reimburse in Texas $45 per treatment regardless if you spend 15

minutes or 2 hours with the patient which is the same payment for an eval.

It is coming to a discussion for my organization, can we afford to continue

speech service. Not to mention we have a waiting list for treatment and are

a month out for evaluations.

Collen Queen, PT

Harlingen, Texas

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[Guest guest]

Dear Listserve: Since we're now getting reimbursed the Medicare rate for

outpatient, I was wondering if any places have lowered what they pay for

contract speech services. I'm working on next year's budget (July 1 for us) and

was asked to research this. Thanks! Ann

Rehab Director

Chesapeake, VA

>>> Mark Dwyer 05/26/99 10:47PM >>>

Collen,

Our outpatient speech evaluations average one hour. Treatment times average 45

minutes. You are right about economical services, especially since Speech evals

and treatments tend to take longer than the other disciplines. Their

productivity never comes close to matching PT and OT, so it is difficult to

reconcile costs and expenses, especially now that Medicare pays per the fee

schedule in outpatient settings.

Mark Dwyer, MHA, PT

Director of Rehabilitation Services

Bethany Medical Center

Kansas City, Kansas

mdwyer1@...

Speech eval time and treatment times

>I am curisous to what other outpatient speech evaluation and treatment times

>are for other facilities. We are seeing new evals for 2 hours and treatments

>for 1 hour. My problem is that with reimbursement based on the procedure

>rather than time, I do not feel we are providing economical services. We

>have good care and good outcomes but that does not cut it as you all know.

>We also see a lot of evaluation only patients that are refered to us by

>school districts that I am told require 2 hours to evaluated and test. What

>are you guys doing and how have you handled the switch from longer to shorter

>treatment / eval times.

>

>Collen Queen, PT

>Harlingen, Texas

>

>------------------------------------------------------------------------

>

>eGroups.com home: /group/ptmanager

> - Simplifying group communications

>

>

>

>

>

------------------------------------------------------------------------

eGroups.com home: /group/ptmanager

- Simplifying group communications

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[Guest guest]

I would challenge the notion that Speech Therapists always have relatively low

productivity. Mine are consistently more productive than my other therapists.

I attribute this " anomoly " to two factors:

First, they have a good sense of how valuable their services are and do not

hesitate to account fully for the time they spend with patients. Often, my PTs

and OTs take the position of " the poor patient can't afford to pay for

everything we do, so... "

Second, it is the only service we provide where we still routinely mix in

patients and out patients in the caseload. So, when they get a cancellation or

a no-show, they fill in the time with an in patient.

Barbee, PT

Dept. Director, Rehabilitation Services

Oregon Health Sciences University Hospital & Clinics

<006c01bea7eb$55716300$926bafc-@preinstalledcom> wrote:

Original Article: /group/ptmanager/?start=5532

> Collen,

>

> Our outpatient speech evaluations average one hour. Treatment times average

45 minutes. You are right about economical services, especially since Speech

evals and treatments tend to take longer than the other disciplines. Their

productivity never comes close to matching PT and OT, so it is difficult to

reconcile costs and expenses, especially now that Medicare pays per the fee

schedule in outpatient settings.

>

> Mark Dwyer, MHA, PT

> Director of Rehabilitation Services

> Bethany Medical Center

> Kansas City, Kansas

> mdwyer1@...

>

> Speech eval time and treatment times

>

>

> >I am curisous to what other outpatient speech evaluation and treatment times

> >are for other facilities. We are seeing new evals for 2 hours and treatments

> >for 1 hour. My problem is that with reimbursement based on the procedure

> >rather than time, I do not feel we are providing economical services. We

> >have good care and good outcomes but that does not cut it as you all know.

> >We also see a lot of evaluation only patients that are refered to us by

> >school districts that I am told require 2 hours to evaluated and test. What

> >are you guys doing and how have you handled the switch from longer to shorter

> >treatment / eval times.

> >

> >Collen Queen, PT

> >Harlingen, Texas

> >

> >------------------------------------------------------------------------

> >

> >eGroups.com home: /group/ptmanager

> > - Simplifying group communications

> >

> >

> >

> >

> >

>

>

------------------------------------------------------------------------

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[Guest guest]

This is my opinion based on personal observation - not fact or

reference-able material.

I think raises an excellent point as we discuss productivity.

Sometimes we confuse being productive with the measurement of

productivity. It has been my experience that many (certainly not

all) rehab therapists tend to under-record the amount of time spent in

patient care. In essence, we " give away " a lot of our

productivity by simply not recording it.

If you have not implemented an intensive productivity and charge capture

system, you can often see recorded charges and productivity increase by

10-15% just by capturing it all.

BTW, it has been my experience that PTs have been the most guilty of

undercharging and under-recording productivity. I believe is

correct that SLP has done a better job at being comfortable with charging

for what we do.

This is a consistent theme of Dick Hillyer's - and I would hope that we

can change this.

At 11:28 AM 5/27/99 , you wrote:

I would challenge the notion that Speech

Therapists always have relatively low productivity. Mine are

consistently more productive than my other therapists. I attribute

this " anomoly " to two factors:

First, they have a good sense of how valuable their services are and do

not hesitate to account fully for the time they spend with

patients. Often, my PTs and OTs take the position of " the poor

patient can't afford to pay for everything we do, so... "

Second, it is the only service we provide where we still routinely mix in

patients and out patients in the caseload. So, when they get a

cancellation or a no-show, they fill in the time with an in patient.

Barbee, PT

Dept. Director, Rehabilitation Services

Oregon Health Sciences University Hospital & Clinics

<006c01bea7eb$55716300$926bafc-@preinstalledcom> wrote:

Original Article:

/group/ptmanager/?start=5532

> Collen,

>

> Our outpatient speech evaluations average one hour. Treatment

times average 45 minutes. You are right about economical services,

especially since Speech evals and treatments tend to take longer than the

other disciplines. Their productivity never comes close to matching

PT and OT, so it is difficult to reconcile costs and expenses, especially

now that Medicare pays per the fee schedule in outpatient settings.

>

> Mark Dwyer, MHA, PT

> Director of Rehabilitation Services

> Bethany Medical Center

> Kansas City, Kansas

> mdwyer1@...

>

> Speech eval time and treatment times

>

>

> >I am curisous to what other outpatient speech evaluation and

treatment times

> >are for other facilities. We are seeing new evals for 2

hours and treatments

> >for 1 hour. My problem is that with reimbursement based on

the procedure

> >rather than time, I do not feel we are providing economical

services. We

> >have good care and good outcomes but that does not cut it as you

all know.

> >We also see a lot of evaluation only patients that are refered

to us by

> >school districts that I am told require 2 hours to evaluated and

test. What

> >are you guys doing and how have you handled the switch from

longer to shorter

> >treatment / eval times.

> >

> >Collen Queen, PT

> >Harlingen, Texas

> >

>

>------------------------------------------------------------------------

> >

> >eGroups.com home:

/group/ptmanager

>

>

- Simplifying group communications

> >

> >

> >

> >

> >

>

>

eGroups.com home:

/group/ptmanager

www. -

Simplifying group communications

R. Kovacek, MSA, PT

Email Pkovacek@...

313 884-8920

Visit

<www.PTManager.com>

TOGETHER WE CAN MAKE A DIFFERENCE !

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[Guest guest]

I agree 100%, being productive does not always produce reimbursable time.

Collen Queen, PT

Harlingen, Texas

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[Guest guest]

my question is, how do you implement an aggressive charge capture system

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[Guest guest]

our problem, in the outpatient setting, is that most insurances don't pay for

speech,therefore it is a lost leader for us. We, in turn, have put our SLP

to prn basis. The new fee schedule only worsens this scenario

Pete

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[Guest guest]

I work in a not for profit hospital and SLP has always (in the past) been

looked at as a service that was an added value for the community. Now we are

having to account for the reimbursement side. It has not been easy! We do

however have a high rate of Medicare and Medicaid and although reimbursement

is low we are still reimbursed. Our private insurances and HMOs are a very

small less than 15% of our total payor mix for SLP. Part of my problem has

been to get my SLP's to understand the gravity of this situation. There

response is that we give really great service that is comprehensive. This

has lead to 2 hour evals and 1 hour treatment sessions with much resistance

to change from this strategy. What are your treatment and eval times?

Collen Queen, PT

Harlingen, Texas

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